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Psoriasis is a skin condition that causes some areas of skin to develop lesions. The appearance of psoriasis varies across different skin tones, and it can be more challenging to diagnose on black skin.

Psoriasis lesions tend to be thick and crusty, and they often form on the scalp, elbows, knees, and back.

In this article, learn about psoriasis on black skin, including its appearance and symptoms as well as how to treat it.

About one-third of people with psoriasis have a relative with the same condition, meaning that genetics is a risk factor.

Psoriasis usually appears between the ages of 15 and 25 years, but it can develop at any age. It is a long-term condition. While there is no cure, many treatment options are available to help manage the symptoms.

Pictures

Image credit: Masryyy, 2017.

Image credit: CDC/ Renelle Woodall, 1969.

Image credit: CDC/ Gavin Hart, 1977.

Image credit: Tim Kubacki, 2018.

Symptoms

Psoriasis presents as thickened areas of skin, sometimes with an overlying scaly crust that may look shiny or silver. These lesions are usually itchy. If a person scratches them, they will bleed and scab over.

In black people, psoriasis can look violet or purple. The individual may also notice areas of darker, thicker skin. In both cases, the lesions can appear scaly. Lesions can develop anywhere on the body, including the scalp.

As psoriasis heals, it can leave areas of discoloration, which can take between 3 and 12 months to disappear.

Psoriasis tends to follow a relapsing-remitting pattern, meaning that people will experience a period of few or no symptoms and then a flare-up of more severe symptoms.

There are several different types of psoriasis, which can vary in their appearance. These are:

Chronic plaque psoriasis

Chronic plaque psoriasis is the most common form of the condition. It causes clearly defined lesions to develop on the elbows, knees, and scalp.

These red or violet lesions are between 1 and 10 centimeters (cm) in diameter and have overlying silvery scales.

Guttate psoriasis

Guttate psoriasis is more common in children or young people recovering from an infection, such as pharyngitis.

It causes small bumps less than 1 cm across to appear on the back, arms, and thighs.

Nail psoriasis

Some people with psoriasis only have symptoms on their nails. Nail psoriasis looks like tiny pinpricks on the fingernails or toenails.

The nails may also turn brown or become thick and crumbly.

Inverse psoriasis

Inverse psoriasis appears on less visible parts of the skin, such as the armpits, the buttocks, the groin, and the folds underneath the breasts. The lesions may be purple or darker than the surrounding skin.

Diagnosis

A doctor may ask about family history to help diagnose psoriasis.

To diagnose psoriasis, a dermatologist will carry out a physical examination and ask questions about the lesions. They will probably also ask about any family history of psoriasis or related conditions, such as arthritis.

Psoriasis on black skin can be difficult to diagnose because it may resemble other skin disorders that are more common in black people.

In some cases, the doctor will also take a skin biopsy so that they can rule out other conditions.

Some people with psoriasis develop lesions on their scalp so doctors may also recommend frequent shampooing with a medicated shampoo.

Summary

Psoriasis is a common skin condition that affects fewer African Americans than white people in the U.S.

In black people, psoriasis may look darker than the surrounding skin or might appear purple. In both cases, it tends to have a scaly overlay. Psoriasis lesions can appear anywhere on the body, including the scalp.

Anyone with symptoms of psoriasis should speak to a doctor about diagnosis and appropriate treatment options.

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